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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Local Anesthetics: Common Agents and Their Applications01:23

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Epidural analgesia and lactation.

Mert Akbas1, A Baris Akcan2

  • 1Department of Anesthesiology, Division of Algology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.

The Eurasian Journal of Medicine
|January 23, 2015
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Summary

Many mothers wish to breastfeed, but epidural analgesia use is rising. This review examines how epidural anesthesia during labor impacts breastfeeding initiation and success.

Keywords:
BreastfeedingEpidural analgesiaLabor

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Area of Science:

  • Obstetrics and Gynecology
  • Lactation Science
  • Anesthesiology

Background:

  • Maternal desire for breastfeeding is increasing.
  • Epidural analgesia use during labor is also rising.
  • A clear consensus on the relationship between epidural analgesia and breastfeeding is lacking.

Purpose of the Study:

  • To evaluate the effect of epidural analgesia on breastfeeding outcomes.
  • To synthesize current evidence on labor epidural anesthesia and its impact on lactation.

Main Methods:

  • Literature review of studies investigating epidural analgesia and breastfeeding.
  • Analysis of research examining the correlation between intrapartum pain management and infant feeding.

Main Results:

  • Evidence suggests a potential association between epidural analgesia and delayed or reduced breastfeeding.
  • Factors such as medication type, dosage, and duration may influence outcomes.
  • Further research is needed to establish causality and identify specific risk factors.

Conclusions:

  • Epidural analgesia may present challenges to successful breastfeeding initiation and maintenance.
  • Healthcare providers should counsel mothers on potential effects and offer support strategies.
  • Optimizing pain management techniques and postnatal support is crucial for promoting breastfeeding.